A coalition of more than 40 medical associations, including the Lung Cancer Alliance, The Society of Thoracic Surgeons, and the American College of Radiology, has written a 28-page letter to the Centers for Medicare & Medicaid Services (CMS) National Coverage and Analysis Group appealing for Medicare coverage of low-dose computed tomography (LDCT) screening for patients at high risk for lung cancer.

In December 2013, the United States Preventive Services Task Force (USPSTF) recommended screening for adults aged 55 to 80 years who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years. A pack-year is defined as smoking one pack per day for 30 years, or two packs per day for 15 years. The letter requests that CMS provide full national coverage for high-risk patients as defined in the USPSTF recommendations and provide evidence-based coverage for other high-risk patients not included in USPSTF recommendations using data collected through existing registries.

“Lung cancer kills more people each year than breast, colon and prostate cancers combined. For each of these other three cancers, there are well-established screening tests and programs. We strongly urge CMS to implement broad national coverage so that those at high risk can be screened, providing the opportunity to save thousands of people each year from this terrible disease,” said Douglas E. Wood, MD immediate past president of The Society of Thoracic Surgeons.

Under the Affordable Care Act, the USPSTF’s grade B recommendation ensures that private insurers must cover the LDCT screening without a co-pay. However, the law does not specify similar coverage for Medicare beneficiaries.

“The USPSTF’s recommendation that made lung cancer screening an essential health benefit specifically included 65 to 80 year olds who are also part of the Medicare population,” said Lung Cancer Alliance President and Chief Executive Officer, Laurie Fenton Ambrose. “If Medicare does not extend full coverage for lung cancer screening to this population, the net effect will be a two tier system that leaves Medicare beneficiaries at greater risk of dying from lung cancer than those with private insurance. This cannot be right.”

Previous studies have shown that low-dose CT screening significantly reduces lung cancer deaths and is cost-effective. The full text of the letter can be viewed on the ACR website.